If in doubt • Never had sexual intercourse buy retrovir 100 mg free shipping, or abstained since they should try to consult with you purchase retrovir 100mg free shipping, because an her last menses/miscarriage/delivery unintended pregnancy is a major occurrence not • Used a reliable contraceptive method consist- only ‘one of those things’ and should be prevented ently and correctly, with a 14 days ‘grace period’ if at all possible. About a quarter of (near) exclu- to advertise that they had obviously violated the sively breastfeeding women restart their periods taboo) and it was/is believed the milk would be- within 6 months post-partum. If a man was polygamous and a for mothers partly separated from their infants be- good offspring rotator, abstinence practiced by one cause of, for example, employment is not easy to wife was probably not a big problem, but otherwise quantify. It is good to consider the relative risks of (near) abstinence of nursing and pregnant women vertical HIV transmission, artificial feeding and the is probably a factor in the spread of STIs. It is a disaster for example if Malawi and Zimbabwe showed many HIV sero- a mother does not breastfeed out of fear of vertical conversions in nursing mothers and hence in their transmission and because of that starts ovulating infants. It seems prudent to discourage this long early and the new child becomes HIV infected (near) abstinence to promote faithfulness. It seems obvious that breastfeeding child spacing methods are however needed in of a HIV-positive mother if she takes anti-retroviral compensation, if extended post-partum abstinence therapy (ART) treatment is best in many circum- declines. There are few tasks more important for a majority of women (81. However, in 2009, an estimated 370,000 were breastfeeding at conception. Many thought children were newly infected with HIV, 90% of breastfeeding would protect them. The relevant The teaching was that not only do COCs in- data and many demographic and FP facts of your crease the already elevated risk of thrombosis in the country may be found at http://www. Six weeks Having sexual intercourse while breastfeeding post-partum, non-breastfeeding women lose their is/was in many areas taboo (women sometimes special position in relation to contraception eligibi- chose an abortion because they were too ashamed lity, although, of course, the younger the child the 151 GYNECOLOGY FOR LESS-RESOURCED LOCATIONS more important a low failure rate is. A recent update countries with millions of Catholics where these from the CDC in the USA advises that COCs are courses are non-existent. In practice in countries okay without breastfeeding from 21 days post- where all contraceptive methods are easily access- partum on condition there are no extra thrombosis ible, only a small percentage of the Catholics use risk factors (family history, smoking, age >35 years, FAB; overall prevalence in W. FAB is breastfeeding, COC can be used from 6 weeks post- unreliable post-partum, after a (spontaneous) abor- partum.